Banner|Aetna

What Banner|Aetna does

Banner|Aetna is an Arizona-based joint venture health insurance company established in 2017 between Banner Health, a regional healthcare delivery system, and Aetna (a CVS Health company). The company offers a comprehensive portfolio of health plans in Arizona, including HMO, PPO, Open Access EPO Plus, Open Access POS II, Open Access Managed Plus, fully insured employer plans, and ERISA-governed self-funded administrative services contracts. Banner|Aetna distributes through direct enterprise sales to employers of all sizes and through a licensed producer/broker network (via the Producer World platform), with member self-service available through the MyPlanPortal member portal (transitioning to the Aetna Health portal).

The company's underlying technology is the CareEngine clinical decision support platform developed by ActiveHealth Management (an Aetna subsidiary), which continuously analyzes claims and clinical data against evidence-based best practices to identify care gaps and clinical inconsistencies. Banner|Aetna layers value-added clinical services on top of its core insurance products, including 24/7/365 text-based virtual primary care through 98point6 by Transcarent, a Type 2 Diabetes Reversal Program through Virta Health, a Mental Wellbeing Resource Center, a multi-disciplinary Care Advocate Team, a 24/7 Nurse On-Call line, and online appointment scheduling. Pharmacy benefits are administered through CVS Caremark mail service and Aetna Specialty Pharmacy; dental and vision benefits are provided through Aetna administrators.

Banner|Aetna generates revenue primarily through recurring health insurance premiums on fully insured plans and managed-services fees on self-funded employer plans. Its four primary customer segments are employers (small and large groups), employee/member covered lives, healthcare professionals participating in the Banner|Aetna provider network, and licensed producers/brokers. Notable named customers include the Town of Gilbert (municipal government), the Pima County Sheriff's Department, and the Arizona Interscholastic Association. As of January 1, 2026, the company exited the individual and family Marketplace segment, refocusing exclusively on employer-sponsored business in Arizona. The company has approximately 51-100 employees and is headquartered in Phoenix, Arizona.

Name

Banner|Aetna

Legal name

Banner Health and Aetna Health Insurance Company and Banner Health and Aetna Health Plan Inc.

Website

https://banneraetna.com

Company type

Private

Founded year

2017

Operating status

Operating

Headcount range

51–100 employees

Short description

Banner|Aetna is an Arizona-based joint venture health insurer between Banner Health and Aetna (CVS Health), offering HMO, PPO, Open Access, and self-funded employer health plans to Arizona employers, with integrated virtual care, diabetes reversal, and clinical decision support.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Agencies, Brokerages, and Other Insurance Related Activities (5242)

SIC

Services-Health Services (8000), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Chronic Condition Medication Programs (e.g., diabetes, hypertension) with Integrated Prescribing (HLALAIAH)

akta.pro secondary industry

Pharmacy/Medication Management & Virtual MTM (Payer-Sponsored) (HLALACAK)

Keywords

• Employer health insurance
• Health plan administration
• HMO PPO plans
• Care management services
• Pharmacy benefits management

Headquarters

HQ city

Phoenix

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Operations, Personnel, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Health Insurance Premiums: Banner|Aetna generates revenue through fully insured health benefit plans where the company bears insurance risk and collects premiums from employers and individuals to cover claims and administrative costs.
2. Administrative Services for Self-Funded Plans: Banner|Aetna provides administrative services for self-insured employer plans, earning fees for claims processing, network access, and care management without bearing insurance risk.
3. Pharmacy Benefits Management: Pharmacy benefits administered by Aetna/CVS Health, including mail order pharmacy (CVS Caremark) and specialty pharmacy services, with rebates from drug manufacturers factored into drug list decisions.
4. Dental and Vision Benefits: Dental benefits provided by Aetna as an administrator of dental insurance plans. Vision benefits available as part of medical plans or through Aetna Vision Preferred.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels6 records

Core offering

Banner|Aetna is an Arizona-based joint venture health insurer that offers fully insured and self-funded employer health plans (HMO, PPO, Open Access EPO Plus, Open Access POS II, Open Access Managed Plus) paired with integrated care programs including the CareEngine clinical decision support system, virtual primary care through 98point6 by Transcarent, and the Virta Health Type 2 Diabetes Reversal Program. The company combines Banner Health's local provider network with Aetna/CVS Health's national insurance and pharmacy infrastructure to deliver payvider-style coverage to Arizona employers and their members.

Product overview

Banner|Aetna is a joint venture health insurer between Banner Health and Aetna (a CVS Health company) offering a comprehensive portfolio of health insurance products and integrated healthcare services in Arizona. The core offering consists of HMO, PPO, Open Access, and EPO health plans for employers and individuals. The company differentiates through integrated care programs including the Type 2 Diabetes Reversal Program through Virta Health, virtual care via 98point6 by Transcarent, a Mental Wellbeing Resource Center, and a Care Advocate Team for personalized care management. Additional services include Nurse On-Call 24/7 support, online appointment scheduling, dental benefits through Aetna Dental, vision benefits through Aetna Vision Preferred, and pharmacy benefits administered by CVS Caremark and Aetna Specialty Pharmacy. The company also operates the CareEngine system for care gap identification.

Differentiator

Problem solved

Functional benefit

Brands

• 98point6 by Transcarent: Virtual care solution providing 24/7/365 text-based primary care through a mobile application partnership with Transcarent.
• Virta Health Diabetes Reversal Program

Products and services

• Banner|Aetna Health Insurance Plans Comprehensive health insurance plans offered to Arizona employers and their employees, available in HMO, PPO, Open Access EPO Plus, Open Access POS II, and Open Access Managed Plus formats with both fully insured and self-funded (ERISA) options.
• Virtual Care through 98point6 by Transcarent

Quantifiable outcome

• 1.4% A1C reduction and 11% average weight loss for Type 2 diabetes reversal program participants
• +2 more outcomes

Named customers3 records

Segments4 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration6 records

AI capability4 records

Feature4 records

Partnerships

Eight partnerships are on record, tiered flagship, core and major.

• Arizona Interscholastic Association (AIA)flagshipGTM or Marketing Partner · 14 May 2026Banner|Aetna named exclusive health insurance partner of the Arizona Interscholastic Association (AIA). The partnership involves sponsoring high school athletic events, hosting community activities such as food drives, and emphasizing health and wellness initiatives for Arizona's student-athletes. CEO Victoria Coley serves as AIA's Official Health Insurance Partner.
• American Heart AssociationflagshipGTM or Marketing Partner · 27 March 2026Banner|Aetna participates in the annual Phoenix Heart Walk organized by the American Heart Association to raise funds for cardiovascular research, education, and disease prevention. Since 2020, Banner|Aetna has ranked among the event's top five fundraisers, contributing to campaigns raising more than $1 million annually. CFO Dan Keller serves on the event's Executive Leadership Team.
• Banner HealthcoreStrategic or Co-development Partner · 1 July 2017Banner|Aetna is a joint venture health insurer formed through partnership between Banner Health (healthcare delivery system) and Aetna (health insurance, part of CVS Health). Banner Health provides the local provider network and clinical expertise, while Aetna provides insurance expertise, technology, and national scale. Each insurer has sole financial responsibility for its own products.
• Aetna (CVS Health)coreStrategic or Co-development Partner · 1 July 2017Aetna, a CVS Health company, partners with Banner Health to operate Banner|Aetna. Aetna provides management services including claims processing, customer service, pharmacy benefits management through CVS Caremark, and access to the CareEngine clinical decision support system. Aetna and its affiliates provide certain management services to Banner|Aetna.
• 98point6 by TranscarentcoreTechnology or IntegrationBanner|Aetna partners with Transcarent (which acquired 98point6) to provide 24/7/365 text-based virtual primary care to members through a mobile app. Members can connect with physicians via text messaging for primary care services.
• Virta HealthcoreStrategic or Co-development PartnerBanner|Aetna partners with Virta Health to offer a Type 2 Diabetes Reversal Program. The clinically-proven program helps members reverse Type 2 diabetes through metabolic health improvement, achieving outcomes including 1.4% A1C reduction and 11% average weight loss. Three years of partnership success with thousands of members achieving diabetes reversal.
• AvailitycoreTechnology or IntegrationBanner|Aetna uses Availity as its provider portal platform, allowing health care professionals to access provider websites, manage claims, and conduct administrative tasks related to Banner|Aetna membership.
• Phoenix Children's HospitalmajorStrategic or Co-development PartnerPhoenix Children's Hospital was highlighted alongside Banner|Aetna as a Modern Healthcare 2023 Top Innovator, indicating collaborative innovation in pediatric healthcare services and outcomes.

Scale indicators5 records

Recent moves8 records

Expansion highlights5 records

Direct peers

• Humana: Humana's Arizona commercial and Medicare Advantage plans overlap with Banner|Aetna on employer-sponsored and senior segments, and share a focus on integrated care management.
• Health Net (Centene subsidiary): Health Net sells commercial and government-sponsored plans in the western U.S. and competes with Banner|Aetna on employer group and individual products in adjacent states.
• UnitedHealthcare Arizona: UnitedHealth Group's Arizona commercial and Medicare business competes head-to-head with Banner|Aetna on large-group employer accounts and provider network breadth, with significantly greater national scale.
• Blue Cross Blue Shield of Arizona: Arizona's incumbent not-for-profit health plan and the most direct in-state competitor, serving employer groups with overlapping HMO/PPO products across the same geography and customer base.
• Cigna Healthcare Arizona: Cigna's Arizona employer and individual plans compete with Banner|Aetna on commercial group accounts and increasingly on integrated care and pharmacy benefit offerings.

Regional players

• Priority Health: Michigan-based regional non-profit health plan that competes on integrated employer-group products and value-based care, providing a comparable regional-carrier peer with similar employer-centric GTM.

Emerging players

• Alignment Health: Tech-enabled Medicare Advantage plan operating in select western states, including Arizona, that competes on integrated care and chronic-disease management — overlapping with Banner|Aetna's Medicare-eligible and chronic-condition segments.
• Oscar Health: Technology-forward ACA Marketplace and small-group insurer focused on consumer experience and virtual care — a comparable emerging playbook to Banner|Aetna's 98point6 integration, though primarily individual rather than employer-focused.

Broad incumbents

• Kaiser Permanente: Kaiser Permanente operates the most established integrated payer-provider model in the U.S. — the same 'payvider' positioning Banner|Aetna is pursuing — providing the reference architecture for the JV's strategic bet.
• Aetna (CVS Health): Banner|Aetna's joint-venture partner and parent provides claims, CareEngine, and pharmacy infrastructure; Aetna's directly-branded commercial plans also overlap with Banner|Aetna's Arizona employer book.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/banner-aetna
• Xx.com/banneraetna

Compliance7 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Banner|Aetna